Revenue Cycle Auditor

About the position

The Revenue Cycle Auditor is responsible for conducting thorough audits of registration, billing, and coding processes to ensure accuracy and compliance with hospital policies, payer requirements, and regulatory standards. This role involves analyzing revenue cycle data to identify discrepancies, trends, and areas of improvement, ensuring compliance with healthcare regulations, including HIPAA and CMS guidelines. The auditor will prepare detailed audit reports, document and communicate results to stakeholders, and collaborate with various departments to implement process improvements. The position requires a commitment to performance in accordance with the organization's values and maintaining effective communication with all patients, staff, and vendors.

Responsibilities

• Conduct thorough audits of registration, billing, and coding processes.
• Analyze revenue cycle data to identify discrepancies and trends.
• Ensure compliance with healthcare regulations, including HIPAA and CMS guidelines.
• Prepare detailed audit reports with findings and recommendations.
• Document and communicate audit results to relevant stakeholders.
• Collaborate with departments to develop and implement process improvements.
• Identify opportunities to optimize revenue capture and minimize leakage.
• Conduct audits on current denials to determine root causes.
• Work with departments to ensure accurate charge capture and coding practices.
• Maintain patient confidentiality at all times.

Requirements

• Must be at least 16 years of age (21 for driving positions).
• Must be able to legally work in the United States.
• Must be able to pass a background check.
• Must be able to pass a drug screen and breath alcohol test (if applicable).
• Bachelor's Degree in Healthcare Administration, Finance, Accounting, or a related field required.
• Minimum of 5 years of experience in healthcare revenue cycle auditing, billing, coding, or related field required.
• Proficiency in Microsoft Excel required.
• Extensive knowledge in CAH and RHC billing and coding practices required.

Nice-to-haves

• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification preferred.
• Proficiency in EPIC preferred.

Benefits

• Medical
• Dental
• Life
• Retirement
• Paid Time Off